Row erupts over consultants’ contract

A MAJOR row is erupting between medical consultants and the HSE over claims some doctors are breaching their contracts by treating almost double the number of private patients than allowed under existing rules.

In recent days the HSE has revealed that 35 senior hospital doctors are failing to limit their private practice work to either the 70:30 or 80:20 public-private ratio requirements drawn up as part of the 2008 consultant contract, which took almost half a decade to negotiate.

As part of these long, drawn-out discussions between the HSE Employers Agency and medical unions the Irish Medical Organisation (IMO) and Irish Hospital Consultants Association (IHCA), it was agreed that senior hospital doctors who signed up to the new category II contract would be paid between €155,000 and €190,000 in return for reducing their private work.

The HSE claims this agreement has been breached. As a result, it is sending letters to these consultants stating they must make payments to hospital research funds as they have spent an inappropriate amount of their working day treating private patients instead of those in the public service. The correspondence will continue that a number of these consultants have been spending up to 50% or more of their time examining private patients “for an extended period of time” and that “adequate” warnings have already been issued highlighting the breach of contract.

However, the IHCA has strongly rejected the claims, stating the only reason the HSE believes these physicians have breached their contracts is because the existing system for calculating the public-private ratio is “flawed”. The group’s assistant secretary general, Donal Duffy, said a significant amount of public patient work is not counted and the resulting figures are distorted. In particular, he claimed doctors are treating huge numbers of public patients in emergency departments, despite these individuals not being counted as part of the public-private ratio.

As a result, the IHCA spokesperson said the HSE claim that thousands of euro will have to be paid back to the system by the 35 doctors who have allegedly breached their contract is inaccurate and will be fought.

“We have challenged them on the system used for measuring the work consultants take because the system is seriously flawed,” Mr Duffy said. “We are talking about 35 consultants out of 2,200. I’m not absolving anybody, but I am saying they (the HSE) must measure all of their activity, and they’re not doing that.

“We won’t know if there’s a problem unless the measurement of work is done properly.”